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Panel Counts

CANADA

Canada’s universal, publicly funded healthcare system—known as Medicare—is a source of national pride, and a model of universal health coverage. Access to health care based on need rather than ability to pay was the founding principle of the Canadian health-care system. The health-care system is less a true national system than a decentralised collection of provincial and territorial insurance plans covering a narrow basket of services, which are free at the point of care. Administration and service delivery are highly decentralised, although coverage is portable across the country. Achievement of the high aspirations of Medicare’s founders requires a enewal of the tripartite social contract between governments, health-care providers, and the public. Expansion of the publicly funded basket of services and coordinated effort to reduce variation in outcomes will hinge on more engaged roles for the federal government and the physician community than have existed in previous decades. Public engagement in system stewardship will also be crucial to achieve a high-quality system grounded in both evidence and the Canadian values of equity and solidarity.